Carrie Friedman is a dual board-certified psychiatric and family nurse practitioner and the founder of Brain Garden Psychiatry in California. She integrates evidence-based psychopharmacology with functional and integrative psychiatry, emphasizing root-cause approaches that connect neuro-nutrition and gut–brain science, metabolic psychiatry, immunology, endocrinology, and mind–body lifestyle medicine. Carrie's clinical focus bridges conventional psychiatry with holistic strategies to support mental health through nutrition, physiology, and sustainable lifestyle interventions. Her professional writing explores topics such as functional medicine, autism, provider well-being, and medical ethics.
Bree is an 11 1/2 year-old, 4.2-pound micro mutt who once lived on the streets of Long Beach. She eventually wound up at Long Beach Animal Care Services, where she sat in a crowded cold cement kennel with no bed, no blanket, no toys, and one very sick basset hound with parvovirus. Every dog in that kennel was scheduled to be euthanized on Christmas Eve 2014. If it weren’t for …
What a tiny dog taught me about the nervous system
A patient in his 20s recently came to see me in a state of severe distress. He described feeling consumed by his thoughts, constantly anxious, unable to function, and deeply exhausted. His sleep had collapsed. His sense of identity felt lost. He was experiencing persistent passive suicidal thoughts, not because he wanted to die, but because everything felt overwhelming and unrelenting.
Within three days of starting low-dose lithium at 150 milligrams …
Low-dose lithium treats suicidal ideation safely
She was 16 the first time she noticed it. Milk. From her breasts. No pregnancy. No childbirth. No explanation. She told a provider. Labs were drawn. Her prolactin was elevated. She was told it was “not a big deal.” Over the years, multiple providers suggested she must be stimulating her nipples and advised her to stop. She insisted she was not. She felt embarrassed, dismissed, and increasingly reluctant to bring …
How diagnostic overshadowing delays hyperprolactinemia care
Delirium is one of the most common and most frustrating syndromes we encounter in medicine. It is also one of the most normalized. Up to 30 to 50 percent of hospitalized older adults experience delirium, particularly in intensive care and post-acute settings, yet it is frequently treated as an expected complication rather than a reversible condition with identifiable drivers. We expect it. We document it. We treat around it. And …
Why thiamine deficiency is a hidden driver of delirium
Autism is typically framed as a neurodevelopmental condition defined by differences in social communication, sensory processing, and behavior. This framing is incomplete. In clinical practice, autistic individuals frequently present with a striking burden of systemic symptoms involving the gastrointestinal tract, cardiovascular regulation, immune signaling, connective tissue, and stress physiology. These are not side notes. They reflect the fact that autism lives within a nervous system that innervates the entire body.
The …
Autism comorbidities: the hidden link between POTS, GI issues, and hypermobility
In functional and integrative psychiatry, patterns start to announce themselves long before they show up in guidelines.
Over the past several months in my clinical practice, I have diagnosed celiac disease in multiple young adult men who presented not with diarrhea, abdominal pain, or weight loss, but with psychiatric and cognitive symptoms: chronic low mood, brain fog, fatigue, poor motivation, memory issues, and anxiety. Neither had prominent gastrointestinal complaints. Both had …
Celiac disease psychiatric symptoms: When anxiety is autoimmune
When my father-in-law died by suicide, our family did not just lose a person. We lost the gravitational center of a small universe.
He was a giant in my eyes. Not because of his curriculum vitae, though his was extraordinary, but because of the way he moved through the world: steady, modest, and relentlessly devoted to the people who needed him.
He had survived what should have broken a human being. As …
Physician suicide: a daughter-in-law’s story of loss and grief
Over the past decade, there has been a marked rise in adolescents and adults seeking autism evaluations. Many of these individuals are intellectually intact, verbally fluent, and professionally capable, yet have lived for decades with persistent social fatigue, sensory sensitivities, difficulty interpreting unspoken social rules, emotional overwhelm, rigid or all-or-nothing thinking, challenges with transitions, and extensive masking or camouflaging behaviors, all without a diagnosis. When they finally seek clarity, the …
Adult autism assessment: ADOS-4 vs. narrative interviewing
When the American Academy of Child and Adolescent Psychiatry released its October 2025 policy statement expanding what counts as valid, evidence-supported autism treatment, it marked a turning point that has been needed for years. For more than a decade, insurance companies pushed a narrow, outdated narrative that applied behavior analysis was the only evidence-based intervention for autism. That narrative was not accurate. It shaped policy, and it left families with …
New autism treatment guidelines expand options for families
Stimulant medications have long been considered the “gold standard” for treating ADHD. When I tell colleagues I don’t prescribe them, I often get pushback: “But it’s the first-line treatment for ADHD!” In my functional and integrative psychiatry practice, I am upfront: I do not prescribe stimulants for ADHD. For patients who are interested in stimulant treatment, I provide referrals to trusted colleagues who do. This decision is not about denying …
Rethinking stimulants for ADHD
I began my career as a nurse practitioner in primary care, where patient visits are often limited to 15 or 20 minutes to manage complex conditions like hypertension, diabetes, and COPD. What struck me was how often these medical issues came with a psychological overlay like depression, anxiety, panic attacks, and trauma. That shaped the course of treatment as much as lab results or medications. The pace of primary care …
A nurse practitioner on leaving the medical machine
When I received an invitation to a webinar titled “Special Session on a New Autism Risk Test,” I expected a discussion on screening strategies or intervention innovations. Instead, when I researched the company and reviewed its website, I discovered a pitch for a punch-biopsy-based lab test marketed as a way to detect autism risk in newborns as early as two days after birth.
As a nurse practitioner who treats autistic patients, …
The ethics of marketing unproven autism tests
At lunch on September 10, 2025, I opened Instagram for a palate cleanser: cute dog videos, life hack reels, something sweet and uplifting. Instead, I ran into a video and headline I wanted to dismiss as a deepfake. It was graphic and disorienting and, for a few seconds, I tried to bargain with reality: This cannot be real, and if it is, how is it on my phone? Would it …
Can a doctor’s personal post violate their oath?
On October 7, 2023, more than 1,200 people were murdered in a single day in the Hamas-led terror attacks in southern Israel, and over 250 individuals were taken hostage. This was the deadliest antisemitic attack since the Holocaust. For many Jewish health care workers, it marked a devastating shift: Our hospitals and clinics were no longer safe, not because of external conflict, but simply because we are Jewish. We had …
The crisis of antisemitism in our hospitals
I have spent decades learning about how bodies and brains work, but nothing has taught me more about complexity than raising my autistic son. He is nine, curious, brilliant, and completely captivated by chemistry. He can explain the structure of an atom with more clarity than most high school students.
But when we step into the real world (classrooms, stores, even family gatherings), sometimes his brain does not get to shine. …
The science behind my son’s sensory overload
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